GP referrals for suspected cancer in Ireland: protocol for a cross-sectional study (GRACCHUS).

Abstract

Background: Cancer is a leading cause of mortality in Ireland, accounting for approximately 30% of deaths annually. Early diagnosis improves survival, reduces treatment burden, and enhances patient outcomes. Rapid Access Clinics (RACs) were introduced to facilitate expedited diagnosis of suspected lung, prostate, and breast cancers, as well as malignant melanoma. However, the extent to which Irish general practitioners (GPs) utilise RAC pathways, and the subsequent diagnostic outcomes, remain poorly understood.

Methods: This retrospective repeated cross-sectional study will analyse electronic health records from Irish general practices (2013-2024). Phase 1 will assess trends in RAC referrals, including volume, cancer type, and inter-practice variation, alongside demographic, geographic, and clinical factors influencing referral rates. Phase 2 will evaluate cancer conversion rates, time to diagnosis, stage at diagnosis, treatment received, and cancer-specific mortality. Data collection will use a validated extraction tool, and analysis will follow STROBE guidelines for observational studies.

Expected outcomes: This study will quantify RAC referral patterns and identify factors influencing variability in GP referral behaviour. It will also assess diagnostic yield and cancer outcomes associated with RAC referrals. Findings will inform quality improvement initiatives and policy development to optimise cancer diagnostic pathways in Ireland.